A scoring tool to identify East African HIV-1 serodiscordant partnerships with a high likelihood of pregnancy

Renee Heffron, Craig R. Cohen, Kenneth Ngure, Elizabeth Bukusi, Edwin Were, James Kiarie, Nelly Mugo, Connie Celum, Jared M. Baeten, Deborah Donnell, Robert W. Coombs, Lisa Frenkel, Craig W. Hendrix, Jairam Lingappa, M. Juliana McElrath, Kenneth Fife, Elioda Tumwesigye, Patrick Ndase, Elly Katabira, Allan Ronald & 46 others Jonathan Wangisi, James Campbell, Jordan Tappero, Carey Farquhar, Grace John-Stewart, Anna Wald, Mary Campbell, Lawrence Corey, James P. Hughes, Amalia Magaret, Rhoda Morrow, James I. Mullins, David Coetzee, Max Essex, Joseph Makhema, Susan Allen, Kayitesi Kayitenkore, Etienne Karita, William Kanweka, Bellington Vwalika, Saidi Kapiga, Rachel Manongi, Mubiana Inambao, Sinead Delany-Moretlwe, Helen Rees, Guy De Bruyn, Glenda Gray, James McIntyre, Ruanne Barnabas, Harald Haugen, Lara Kidoguchi, Susan Morrison, Jennifer Morton, Andrew Mujugira, Caitlin Scoville, Bettina Shell-Duncan, Kathy Thomas, Steven Asiimwe, Edna Tindimwebwa, Nulu Bulya, Josephine Odoyo, David Bangsberg, Jessica Haberer, Norma Ware, Monique Wyatt, Mark Marzinke.

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception) or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year. Methods: Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects. Results: The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC) for the probability of the score to correctly predict pregnancy was 0.74 (95% CI 0.72-0.76). Scores ≥7 predicted a pregnancy incidence of >17% per year and captured 78% of the pregnancies. Internal and external validation confirmed the predictive ability of the score. Discussion: A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

Original languageEnglish (US)
Article numbere0145515
JournalPLoS One
Volume10
Issue number12
DOIs
StatePublished - Dec 1 2015

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Human immunodeficiency virus 1
HIV-1
pregnancy
Pregnancy
Contraceptive Agents
contraception
Contraception
incidence
contraceptives
Aptitude
Uganda
prediction
counseling
Kenya
Heterosexuality
Incidence
Pregnancy Rate
Area Under Curve
Fertility
Counseling

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Heffron, R., Cohen, C. R., Ngure, K., Bukusi, E., Were, E., Kiarie, J., ... Marzinke., M. (2015). A scoring tool to identify East African HIV-1 serodiscordant partnerships with a high likelihood of pregnancy. PLoS One, 10(12), [e0145515]. https://doi.org/10.1371/journal.pone.0145515

A scoring tool to identify East African HIV-1 serodiscordant partnerships with a high likelihood of pregnancy. / Heffron, Renee; Cohen, Craig R.; Ngure, Kenneth; Bukusi, Elizabeth; Were, Edwin; Kiarie, James; Mugo, Nelly; Celum, Connie; Baeten, Jared M.; Donnell, Deborah; Coombs, Robert W.; Frenkel, Lisa; Hendrix, Craig W.; Lingappa, Jairam; McElrath, M. Juliana; Fife, Kenneth; Tumwesigye, Elioda; Ndase, Patrick; Katabira, Elly; Ronald, Allan; Wangisi, Jonathan; Campbell, James; Tappero, Jordan; Farquhar, Carey; John-Stewart, Grace; Wald, Anna; Campbell, Mary; Corey, Lawrence; Hughes, James P.; Magaret, Amalia; Morrow, Rhoda; Mullins, James I.; Coetzee, David; Essex, Max; Makhema, Joseph; Allen, Susan; Kayitenkore, Kayitesi; Karita, Etienne; Kanweka, William; Vwalika, Bellington; Kapiga, Saidi; Manongi, Rachel; Inambao, Mubiana; Delany-Moretlwe, Sinead; Rees, Helen; De Bruyn, Guy; Gray, Glenda; McIntyre, James; Barnabas, Ruanne; Haugen, Harald; Kidoguchi, Lara; Morrison, Susan; Morton, Jennifer; Mujugira, Andrew; Scoville, Caitlin; Shell-Duncan, Bettina; Thomas, Kathy; Asiimwe, Steven; Tindimwebwa, Edna; Bulya, Nulu; Odoyo, Josephine; Bangsberg, David; Haberer, Jessica; Ware, Norma; Wyatt, Monique; Marzinke., Mark.

In: PLoS One, Vol. 10, No. 12, e0145515, 01.12.2015.

Research output: Contribution to journalArticle

Heffron, R, Cohen, CR, Ngure, K, Bukusi, E, Were, E, Kiarie, J, Mugo, N, Celum, C, Baeten, JM, Donnell, D, Coombs, RW, Frenkel, L, Hendrix, CW, Lingappa, J, McElrath, MJ, Fife, K, Tumwesigye, E, Ndase, P, Katabira, E, Ronald, A, Wangisi, J, Campbell, J, Tappero, J, Farquhar, C, John-Stewart, G, Wald, A, Campbell, M, Corey, L, Hughes, JP, Magaret, A, Morrow, R, Mullins, JI, Coetzee, D, Essex, M, Makhema, J, Allen, S, Kayitenkore, K, Karita, E, Kanweka, W, Vwalika, B, Kapiga, S, Manongi, R, Inambao, M, Delany-Moretlwe, S, Rees, H, De Bruyn, G, Gray, G, McIntyre, J, Barnabas, R, Haugen, H, Kidoguchi, L, Morrison, S, Morton, J, Mujugira, A, Scoville, C, Shell-Duncan, B, Thomas, K, Asiimwe, S, Tindimwebwa, E, Bulya, N, Odoyo, J, Bangsberg, D, Haberer, J, Ware, N, Wyatt, M & Marzinke., M 2015, 'A scoring tool to identify East African HIV-1 serodiscordant partnerships with a high likelihood of pregnancy', PLoS One, vol. 10, no. 12, e0145515. https://doi.org/10.1371/journal.pone.0145515
Heffron, Renee ; Cohen, Craig R. ; Ngure, Kenneth ; Bukusi, Elizabeth ; Were, Edwin ; Kiarie, James ; Mugo, Nelly ; Celum, Connie ; Baeten, Jared M. ; Donnell, Deborah ; Coombs, Robert W. ; Frenkel, Lisa ; Hendrix, Craig W. ; Lingappa, Jairam ; McElrath, M. Juliana ; Fife, Kenneth ; Tumwesigye, Elioda ; Ndase, Patrick ; Katabira, Elly ; Ronald, Allan ; Wangisi, Jonathan ; Campbell, James ; Tappero, Jordan ; Farquhar, Carey ; John-Stewart, Grace ; Wald, Anna ; Campbell, Mary ; Corey, Lawrence ; Hughes, James P. ; Magaret, Amalia ; Morrow, Rhoda ; Mullins, James I. ; Coetzee, David ; Essex, Max ; Makhema, Joseph ; Allen, Susan ; Kayitenkore, Kayitesi ; Karita, Etienne ; Kanweka, William ; Vwalika, Bellington ; Kapiga, Saidi ; Manongi, Rachel ; Inambao, Mubiana ; Delany-Moretlwe, Sinead ; Rees, Helen ; De Bruyn, Guy ; Gray, Glenda ; McIntyre, James ; Barnabas, Ruanne ; Haugen, Harald ; Kidoguchi, Lara ; Morrison, Susan ; Morton, Jennifer ; Mujugira, Andrew ; Scoville, Caitlin ; Shell-Duncan, Bettina ; Thomas, Kathy ; Asiimwe, Steven ; Tindimwebwa, Edna ; Bulya, Nulu ; Odoyo, Josephine ; Bangsberg, David ; Haberer, Jessica ; Ware, Norma ; Wyatt, Monique ; Marzinke., Mark. / A scoring tool to identify East African HIV-1 serodiscordant partnerships with a high likelihood of pregnancy. In: PLoS One. 2015 ; Vol. 10, No. 12.
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abstract = "Introduction: HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception) or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year. Methods: Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects. Results: The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC) for the probability of the score to correctly predict pregnancy was 0.74 (95{\%} CI 0.72-0.76). Scores ≥7 predicted a pregnancy incidence of >17{\%} per year and captured 78{\%} of the pregnancies. Internal and external validation confirmed the predictive ability of the score. Discussion: A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.",
author = "Renee Heffron and Cohen, {Craig R.} and Kenneth Ngure and Elizabeth Bukusi and Edwin Were and James Kiarie and Nelly Mugo and Connie Celum and Baeten, {Jared M.} and Deborah Donnell and Coombs, {Robert W.} and Lisa Frenkel and Hendrix, {Craig W.} and Jairam Lingappa and McElrath, {M. Juliana} and Kenneth Fife and Elioda Tumwesigye and Patrick Ndase and Elly Katabira and Allan Ronald and Jonathan Wangisi and James Campbell and Jordan Tappero and Carey Farquhar and Grace John-Stewart and Anna Wald and Mary Campbell and Lawrence Corey and Hughes, {James P.} and Amalia Magaret and Rhoda Morrow and Mullins, {James I.} and David Coetzee and Max Essex and Joseph Makhema and Susan Allen and Kayitesi Kayitenkore and Etienne Karita and William Kanweka and Bellington Vwalika and Saidi Kapiga and Rachel Manongi and Mubiana Inambao and Sinead Delany-Moretlwe and Helen Rees and {De Bruyn}, Guy and Glenda Gray and James McIntyre and Ruanne Barnabas and Harald Haugen and Lara Kidoguchi and Susan Morrison and Jennifer Morton and Andrew Mujugira and Caitlin Scoville and Bettina Shell-Duncan and Kathy Thomas and Steven Asiimwe and Edna Tindimwebwa and Nulu Bulya and Josephine Odoyo and David Bangsberg and Jessica Haberer and Norma Ware and Monique Wyatt and Mark Marzinke.",
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T1 - A scoring tool to identify East African HIV-1 serodiscordant partnerships with a high likelihood of pregnancy

AU - Heffron, Renee

AU - Cohen, Craig R.

AU - Ngure, Kenneth

AU - Bukusi, Elizabeth

AU - Were, Edwin

AU - Kiarie, James

AU - Mugo, Nelly

AU - Celum, Connie

AU - Baeten, Jared M.

AU - Donnell, Deborah

AU - Coombs, Robert W.

AU - Frenkel, Lisa

AU - Hendrix, Craig W.

AU - Lingappa, Jairam

AU - McElrath, M. Juliana

AU - Fife, Kenneth

AU - Tumwesigye, Elioda

AU - Ndase, Patrick

AU - Katabira, Elly

AU - Ronald, Allan

AU - Wangisi, Jonathan

AU - Campbell, James

AU - Tappero, Jordan

AU - Farquhar, Carey

AU - John-Stewart, Grace

AU - Wald, Anna

AU - Campbell, Mary

AU - Corey, Lawrence

AU - Hughes, James P.

AU - Magaret, Amalia

AU - Morrow, Rhoda

AU - Mullins, James I.

AU - Coetzee, David

AU - Essex, Max

AU - Makhema, Joseph

AU - Allen, Susan

AU - Kayitenkore, Kayitesi

AU - Karita, Etienne

AU - Kanweka, William

AU - Vwalika, Bellington

AU - Kapiga, Saidi

AU - Manongi, Rachel

AU - Inambao, Mubiana

AU - Delany-Moretlwe, Sinead

AU - Rees, Helen

AU - De Bruyn, Guy

AU - Gray, Glenda

AU - McIntyre, James

AU - Barnabas, Ruanne

AU - Haugen, Harald

AU - Kidoguchi, Lara

AU - Morrison, Susan

AU - Morton, Jennifer

AU - Mujugira, Andrew

AU - Scoville, Caitlin

AU - Shell-Duncan, Bettina

AU - Thomas, Kathy

AU - Asiimwe, Steven

AU - Tindimwebwa, Edna

AU - Bulya, Nulu

AU - Odoyo, Josephine

AU - Bangsberg, David

AU - Haberer, Jessica

AU - Ware, Norma

AU - Wyatt, Monique

AU - Marzinke., Mark

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Introduction: HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception) or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year. Methods: Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects. Results: The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC) for the probability of the score to correctly predict pregnancy was 0.74 (95% CI 0.72-0.76). Scores ≥7 predicted a pregnancy incidence of >17% per year and captured 78% of the pregnancies. Internal and external validation confirmed the predictive ability of the score. Discussion: A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

AB - Introduction: HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception) or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year. Methods: Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects. Results: The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC) for the probability of the score to correctly predict pregnancy was 0.74 (95% CI 0.72-0.76). Scores ≥7 predicted a pregnancy incidence of >17% per year and captured 78% of the pregnancies. Internal and external validation confirmed the predictive ability of the score. Discussion: A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

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